scholarly journals Real life turnaround time of blood cultures in the clinical microbiology laboratory: results of the first Italian survey, May 2015

2016 ◽  
Vol 31 (3) ◽  
Author(s):  
Fabio Arena ◽  
Marta Argentieri ◽  
Paola Bernaschi ◽  
Giacomo Fortina ◽  
Vesselina Kroumova ◽  
...  
Keyword(s):  
Molecular Identification ◽  
Susceptibility Testing ◽  
Real Life ◽  
Turnaround Time ◽  
High Rate ◽  
Clinical Microbiology Laboratory ◽  
Microbiology Laboratory ◽  
Italian Survey ◽  
Multiple Outcome ◽  
Reported Data

<em>Background and aims</em>: Blood culture (BC) results are essential to guide antimicrobial chemotherapy for patients with sepsis. However, BC is a time-consuming exam, which can take several days. Reducing BCs turn around time (TAT) could impact on multiple outcome parameters and TAT monitoring is an important tool for measurement of microbiology laboratory performance. The aim of this study was to provide an overview of BC TATs among Italian microbiology laboratories. <br /><em>Materials and methods</em>: Five laboratories collected and recorded, for a month period, date and time of the BC processing events. Cumulative TATs were analysed using the GraphPad software. <br /><em>Results</em>: Participating laboratories reported data from 302 sepsis episodes. The median time from when the BC system produced a positive signal until Gram-stain results were reported was 7.6 hours. A rapid molecular identification and antimicrobial susceptibility testing (AST) was performed in 26.5% of BCs. Mean TAT for identification report was significantly lower when a molecular approach was adopted (12 vs. 28.7 hours, P&lt;0.001). Similarly, results of the molecular AST were obtained more than 24 hours in advance compared with phenotypic AST (mean 13.2 vs. 47.6, P&lt;0.001). TATs from BC positivity of laboratories opened 7 days/week were not significantly lower than those of laboratories opened 6 days/week. <br /><em>Conclusions</em>: BC is a time-consuming exam, however, molecular identification and AST methods can drastically reduce time to results. The lack of difference between TATs observed for laboratories working 7 days/week and 6 days/week, coupled with a high rate of BCs turning positive during the night enable to conclude that the most urgent measure to reduce TATs is the expansion of laboratory regular duty hours.

scholarly journals Serotype Is Associated With High Rate of Colistin Resistance Among Clinical Isolates of Salmonella

2020 ◽  
Vol 11 ◽  
Author(s):  
Qixia Luo ◽  
Yuan Wang ◽  
Hao Fu ◽  
Xiao Yu ◽  
Beiwen Zheng ◽  
...  
Keyword(s):  
Clinical Microbiology ◽  
Core Genome ◽  
Clinical Isolates ◽  
High Rate ◽  
Clinical Microbiology Laboratory ◽  
Nucleotide Polymorphisms ◽  
Microbiology Laboratory ◽  
Colistin Resistance ◽  
Single Nucleotide ◽  
Blood Samples

To investigate the prevalence, probable mechanisms and serotype correlation of colistin resistance in clinical isolates of Salmonella from patients in China, Salmonella isolates were collected from fecal and blood samples of patients. In this study, 42.8% (136/318) clinical isolated Salmonella were resistant to colistin. MIC distribution for colistin at serotype level among the two most prevalent serotypes originating from humans in China indicated that Salmonella Enteritidis (83.9% resistance, 125/149) were significantly less susceptible than Salmonella Typhimurium (15.3% resistance, 9/59, P &lt; 0.01). mcr genes and mutations in PmrAB confer little for rate of colistin resistant Salmonella isolated from human patients. Phylogenetic tree based on core-genome single nucleotide polymorphisms (SNPs) was separately by the serotypes and implied a diffused distribution of MICs in the same serotype isolates. Relatvie expression levels of colistin resistant related pmr genes were significantly higher in non-mcr colistin resistant S. Typhimurium than in colistin sensitive S. Typhimurium, but no discernable differences between colistin resistant and sensitive S. Enteritidis, indicating a different mechanism between colistin resistant S. Typhimurium and S. Enteritidis. In conclusion, colistin susceptibility and colistin resistant mechanism of clinical isolated Salmonella were closely associated with specific serotypes, at least in the two most prevalent serotype Enteritidis and Typhimurium. We suggest clinical microbiology laboratory interpreting Salmonella colistin MIC results in the serotype level.

scholarly journals Validation of Sensititre Dry-Form Broth Microdilution Panels for Susceptibility Testing of Ceftazidime-Avibactam, a Broad-Spectrum-β-Lactamase Inhibitor Combination

2015 ◽  
Vol 59 (8) ◽  
pp. 5036-5039 ◽  
Author(s):  
Ronald N. Jones ◽  
Nicole M. Holliday ◽  
Kevin M. Krause
Keyword(s):  
Broad Spectrum ◽  
Susceptibility Testing ◽  
Clinical Microbiology Laboratory ◽  
Microbiology Laboratory ◽  
Broth Microdilution ◽  
Content Type ◽  
Serious Infections ◽  
Validation Experiment ◽  
Inhibitor Combination ◽  
Lactamase Inhibitor

ABSTRACTCeftazidime-avibactam is a broad-spectrum-β-lactamase inhibitor combination in late-stage clinical development for the treatment of serious infections. In preparation for clinical microbiology laboratory use, a validation experiment was initiated to evaluate a commercial broth microdilution product (Sensititre dried MIC susceptibility system) compared to reference panels using 525 recent clinical isolates. Among 11 pathogen groups, all had Sensititre MIC/reference MIC ratios predominantly at 1 (47.5% to 97.5%), and automated and manual endpoint results did not differ.EnterobacteriaceaeMIC comparisons showed a modest skewing of Sensititre MIC results toward an elevated MIC (33.9%), but the essential agreement was 98.9% with 100.0% reproducibility. In conclusion, Sensititre panels produced accurate ceftazidime-avibactam MIC results, allowing quality MIC guidance for therapy following regulatory approvals.

Prospective evaluation of the VITEK MS for the routine identification of bacteria and yeast in the clinical microbiology laboratory: assessment of accuracy of identification and turnaround time

2014 ◽  
Vol 63 (2) ◽  
pp. 235-241 ◽  
Author(s):  
Angella Charnot-Katsikas ◽  
Vera Tesic ◽  
Sue Boonlayangoor ◽  
Cindy Bethel ◽  
Karen M. Frank
Keyword(s):  
Clinical Microbiology ◽  
Clinical Care ◽  
Turnaround Time ◽  
Clinical Microbiology Laboratory ◽  
Microbiology Laboratory ◽  
Laboratory Assessment ◽  
16S Rrna Sequence ◽  
Routine Identification ◽  
Vitek 2 ◽  
Vitek Ms

This study assessed the accuracy of bacterial and yeast identification using the VITEK MS, and the time to reporting of isolates before and after its implementation in routine clinical practice. Three hundred and sixty-two isolates of bacteria and yeast, consisting of a variety of clinical isolates and American Type Culture Collection strains, were tested. Results were compared with reference identifications from the VITEK 2 system and with 16S rRNA sequence analysis. The VITEK MS provided an acceptable identification to species level for 283 (78 %) isolates. Considering organisms for which genus-level identification is acceptable for routine clinical care, 315 isolates (87 %) had an acceptable identification. Six isolates (2 %) were identified incorrectly, five of which were Shigella species. Finally, the time for reporting the identifications was decreased significantly after implementation of the VITEK MS for a total mean reduction in time of 10.52 h (P<0.0001). Overall, accuracy of the VITEK MS was comparable or superior to that from the VITEK 2. The findings were also comparable to other studies examining the accuracy of the VITEK MS, although differences exist, depending on the diversity of species represented as well as on the versions of the databases used. The VITEK MS can be incorporated effectively into routine use in a clinical microbiology laboratory and future expansion of the database should provide improved accuracy for the identification of micro-organisms.

scholarly journals Clinical Microbiology Is Growing Up: The Total Laboratory Automation Revolution

2019 ◽  
Vol 65 (5) ◽  
pp. 634-643 ◽  
Author(s):  
Adam L Bailey ◽  
Nathan Ledeboer ◽  
Carey-Ann D Burnham
Keyword(s):  
Laboratory Testing ◽  
Clinical Microbiology ◽  
Turnaround Time ◽  
Automation System ◽  
Clinical Microbiology Laboratory ◽  
Laboratory Automation ◽  
Microbiology Laboratory ◽  
Total Laboratory Automation ◽  
The Impact ◽  
Automated Methods

Abstract BACKGROUND Historically, culture-based microbiology laboratory testing has relied on manual methods, and automated methods (such as those that have revolutionized clinical chemistry and hematology over the past several decades) were largely absent from the clinical microbiology laboratory. However, an increased demand for microbiology testing and standardization of sample-collection devices for microbiology culture, as well as a dwindling supply of microbiology technologists, has driven the adoption of automated methods for culture-based laboratory testing in clinical microbiology. CONTENT We describe systems currently enabling total laboratory automation (TLA) for culture-based microbiology testing. We describe the general components of a microbiology automation system and the various functions of these instruments. We then introduce the 2 most widely used systems currently on the market: Becton Dickinson's Kiestra TLA and Copan's WASPLab. We discuss the impact of TLA on metrics such as turnaround time and recovery of microorganisms, providing a review of the current literature and perspectives from laboratory directors, managers, and technical staff. Finally, we provide an outlook for future advances in TLA for microbiology with a focus on artificial intelligence for automated culture interpretation. SUMMARY TLA is playing an increasingly important role in clinical microbiology. Although challenges remain, TLA has great potential to affect laboratory efficiency, turnaround time, and the overall quality of culture-based microbiology testing.

scholarly journals Hospital microbiology laboratory practices for Enterobacteriaceae: Centers for Disease Control and Prevention National Healthcare Safety Network (NHSN) annual survey, 2015 and 2016

2018 ◽  
Vol 39 (9) ◽  
pp. 1115-1117 ◽  
Author(s):  
Alicia Shugart ◽  
Maroya Spalding Walters ◽  
Lindsey M. Weiner ◽  
David Lonsway ◽  
Alexander J. Kallen
Keyword(s):  
Susceptibility Testing ◽  
Multidrug Resistant ◽  
Clinical Microbiology Laboratory ◽  
Microbiology Laboratory ◽  
National Healthcare ◽  
Annual Survey ◽  
National Healthcare Safety Network ◽  
Control And Prevention ◽  
Using Data ◽  
Facility Survey

AbstractWe analyzed clinical microbiology laboratory practices for detection of multidrug-resistant Enterobacteriaceae in US short-stay acute-care hospitals using data from the National Healthcare Safety Network (NHSN) Annual Facility Survey. Half of hospitals reported testing for carbapenemases, and 1% performed routine polymyxin susceptibility testing using reference broth microdilution.

scholarly journals Detecting In-Vitro Colistin Resistance- A Comparative Study Between Broth Microdilution Versus Vitek-2 For Colistin Susceptibility Testing

2020 ◽  
Vol 7 (7) ◽  
pp. A336-340
Author(s):  
Hena Butta ◽  
Leena Mendiratta ◽  
Raman Sardana ◽  
Kirti Gilotra ◽  
Sana Hasan ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Pseudomonas Aeruginosa ◽  
Clinical Microbiology ◽  
Susceptibility Testing ◽  
Clinical Microbiology Laboratory ◽  
Microbiology Laboratory ◽  
Broth Microdilution ◽  
Major Error ◽  
Acinetobacter Baumanii ◽  
Vitek 2

Background: Susceptibility testing for polymyxins is a great challenge for a Clinical Microbiology laboratory. There are several methodological issues associated with MIC (Minimum Inhibitory Concentration) determination of colistin. Methods: In our study, we have compared the results of colistin susceptibility testing by Automated system (Vitek-2, Biomerieux, France) with the reference Broth Microdilution method (BMD) to identify the type of discrepancies by Vitek-2 method and thus develop a practical and accurate approach for colistin susceptibility testing in a Clinical Microbiology laboratory. A total of 730 strains of Gram negative bacteria [Escherichia coli (325), Klebsiella sp.(346), Acinetobacter baumanii complex (37) and Pseudomonas aeruginosa (22)] from 485 patents were tested simultaneously by BMD and Vitek-2 method for colistin susceptibility testing. Results: The Essential agreement (EA), Categorical agreement (CA), Very major error (VME) and Major error (ME) rates for Klebsiella sp. were 87.3%, 89.3%, 8% and 2.3% respectively, for Escherichia coli were 88.3%, 89.5%, 9.2% and 1.2%  respectively, for Acinetobacter baumannii complex were 89.1%, 91.8%, 8.1% and 0% respectively, for Pseudomonas aeruginosa were 68.1%, 72.7%, 0% and 27.2% respectively. Conclusions: Colistin susceptibility testing by Vitek-2 method is an easily adoptable method and the results of Vitek-2 with reference to BMD are acceptable to a great extent in Klebsiella sp., Escherichia coli and Acinetobacter baumanii complex. So, we believe that Vitek-2 method may be used for colistin susceptibility testing in low risk patients. However, BMD should be used in high risk immunosupressed and immunocompromised patients who are admitted in critical care units. For Pseudomonas aeruginosa, BMD should be routinely used.

Systematic Assessment of Culture Review as a Tool to Assess Errors in the Clinical Microbiology Laboratory

2008 ◽  
Vol 132 (11) ◽  
pp. 1792-1795
Author(s):  
Nancy Goodyear ◽  
Bruce K. Ulness ◽  
Jennifer L. Prentice ◽  
Brad T. Cookson ◽  
Ajit P. Limaye
Keyword(s):  
Clinical Microbiology ◽  
Susceptibility Testing ◽  
Positive Culture ◽  
The United States ◽  
Error Rates ◽  
Clinical Microbiology Laboratory ◽  
Microbiology Laboratory ◽  
Negative Culture ◽  
Clinically Significant ◽  
Potentially Clinically Significant

Abstract Context.—Daily supervisory review is a common practice in microbiology laboratories; however, there are no publications describing errors corrected by this practice. Objective.—To determine (1) the correction rates for routinely reviewed positive cultures, (2) the correction rates for negative cultures, and (3) the types of corrections that are found, including the number with potential clinical significance. Design.—We prospectively assessed errors identified during culture report review for all positive (10-month period) and negative (1-month period) cultures at a single, university-based clinical microbiology laboratory in the United States. Errors were classified using predefined categories, and total and per category error rates were determined. A χ2 test was used to assess significant differences between error rates. Results.—A total of 112 108 culture reports were examined; 914 reports required a total of 1043 corrections. Of 101 703 positive culture reports, 786 (0.8%) required 900 corrections, 302 (0.3%) of which were potentially clinically significant. Of 10 405 negative culture reports, 128 (1.2%) required 143 corrections, 5 (0.05%) of which were potentially clinically significant. The rate of potentially clinically significant errors was significantly higher among positive versus negative culture reports (P &lt; .001). Errors from positive culture reports most commonly involved susceptibility (374 [42%]), reporting (275 [31%]), and identification workup (217 [24%]). Most potentially significant errors from positive culture reports involved susceptibility testing (n = 253) and specimens from wound or lower respiratory tract (P &lt; .001). Conclusions.—Review of culture reports from positive cultures from nonsterile sites with special attention to antimicrobial susceptibility testing and reporting would be most likely to detect potentially significant errors within the clinical microbiology laboratory.

scholarly journals The Poisoned Well: Enhancing the Predictive Value of Antimicrobial Susceptibility Testing in the Era of Multidrug Resistance

2017 ◽  
Vol 55 (8) ◽  
pp. 2304-2308 ◽  
Author(s):  
Thea Brennan-Krohn ◽  
Kenneth P. Smith ◽  
James E. Kirby
Keyword(s):  
Antimicrobial Susceptibility ◽  
Clinical Microbiology ◽  
Predictive Power ◽  
Susceptibility Testing ◽  
Reference Method ◽  
Antimicrobial Susceptibility Testing ◽  
Clinical Microbiology Laboratory ◽  
Microbiology Laboratory ◽  
Laboratory Reference ◽  
Doubling Dilution

ABSTRACTAntimicrobial susceptibility testing (AST) is a fundamental mission of the clinical microbiology laboratory. Reference AST methods are based on bacterial growth in antibiotic doubling dilution series, which means that any error in the reference method inherently represents at least a 2-fold difference. We describe the origins of current AST reference methodology, highlight the sources of AST variability, and propose ideas for improving AST predictive power.

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